Irish Journal of Medical Science最新文献

{"title":"Perinatal deaths in twin and singleton infants in Ireland: A comparison of characteristics and causes.","authors":"Caroline O'Connor, Sara Leitao, Paul Corcoran, Keelin O'Donoghue","doi":"10.1007/s11845-024-03829-9","DOIUrl":"10.1007/s11845-024-03829-9","url":null,"abstract":"<p><strong>Introduction: </strong>Twin pregnancies are associated with significantly higher perinatal mortality (PM) rates compared to singletons, primarily due to complications like fetal growth restriction, preterm birth, and congenital anomalies. This study aimed to compare the characteristics associated with PM in twin pregnancies and compare maternal and obstetric factors and cause of death among twins and singletons in the Republic of Ireland.</p><p><strong>Materials and methods: </strong>Data spanning 2011 to 2022 from the National Perinatal Epidemiology Centre's annual perinatal mortality clinical audit included 4494 perinatal deaths. Maternal characteristics, antenatal care factors and cause of death were analysed with relative risk calculated using national Hospital In-Patient Enquiry data. Pearson's chi-squared tests studied the difference between mortality in twins and singletons.</p><p><strong>Results: </strong>Twins accounted for 10.4% of all perinatal deaths, despite representing only 3.6% of total births. The PM rate for twins was 17.3 per 1000 births, 3.1 times higher than for singletons. Early neonatal deaths (ENNDs) were more frequent in twins (54.2%), while stillbirths predominated among singletons (68.6%). Younger maternal age and lower BMI were associated with higher PM risks in twins. A considerable proportion of twin deaths with major congenital anomalies or birth before 28 weeks gestation occurred in non-tertiary hospitals, suggesting limitations in referral pathways to centres with appropriate neonatal expertise.</p><p><strong>Conclusion: </strong>Twin pregnancies pose a higher risk of perinatal mortality, particularly among younger mothers and preterm births. The findings highlight the need for updated guidelines that prioritise early risk assessment, targeted interventions, and improved referral systems.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"167-180"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of NT-proBNP for major adverse cardiovascular events within a 6-month period in patients with acute coronary syndrome.","authors":"Ozlem Canan Ozbaltan, Sumeyye Cakmak, Ozgur Sogut, Adem Az, Hasan Ogur","doi":"10.1007/s11845-024-03849-5","DOIUrl":"10.1007/s11845-024-03849-5","url":null,"abstract":"<p><strong>Background: </strong>The role of NT-proBNP as a cardiac biomarker for predicting short-term major adverse cardiovascular events (MACEs) in acute coronary syndrome (ACS) remains unclear.</p><p><strong>Aims: </strong>This study investigated the utility of the NT-proBNP level for predicting MACEs within a 6-month period in patients with ACS.</p><p><strong>Methods: </strong>This prospective study included 241 consecutively enrolled adults with ACS between September 2023 and February 2024. Demographic data, clinical characteristics, GRACE score, and high-sensitivity cardiac troponin T (hs-cTnT) and NT-proBNP levels were compared between patients who were MACE-positive vs. MACE-negative within a 6-month period.</p><p><strong>Results: </strong>The overall mortality rate was 8.7%, and the incidence of MACEs was 43.2%. The mean serum levels of hs-cTnT and NT-proBNP were significantly higher in the MACE-positive than in the MACE-negative group. Age, concomitant coronary artery disease, NT-proBNP, and GRACE score were independent predictors of MACEs in patients with ACS. An NT-proBNP level of 250 pg/mL had a sensitivity of 73.1% and a specificity of 88.3% for predicting MACEs, with an area under the curve of 0.847. The estimated risk of MACEs was 70% and 90% for NT-proBNP values of 600 pg/mL and 900 pg/mL, respectively.</p><p><strong>Conclusion: </strong>The NT-proBNP level measured at ED admission was strongly associated with short-term MACEs in patients with all ACS subtypes and was an important prognostic biomarker. Therefore, combining the NT-proBNP level with the GRACE score in ACS patients may provide significant benefits in terms of predicting MACEs and obtaining a more accurate risk stratification.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"71-77"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The clinical significance and burden of thyroid nodules discovered incidentally.","authors":"Rohil F Dureja, Caoimhe Casey, Josephine Barry, Antoinette Tuthill","doi":"10.1007/s11845-024-03858-4","DOIUrl":"10.1007/s11845-024-03858-4","url":null,"abstract":"<p><strong>Background: </strong>The majority of thyroid nodules are benign; however current guidelines suggest that thyroid incidentalomas should be appropriately evaluated to rule out malignancy.</p><p><strong>Aims: </strong>This study aims to determine the incidence of thyroid incidentalomas and the likelihood that they harbour sinister pathology in the largest Irish cohort studied to-date.</p><p><strong>Methods: </strong>A retrospective observational chart review was conducted using data from July 2018 to December 2018 using the Radiology Database in use at Cork University Hospital. The text of 1000 imaging reports (500 carotid Doppler and 500 computed tomography thorax) was manually screened for phrases such as \"thyroid mass\" or \"thyroid nodule\".</p><p><strong>Results: </strong>On 1000 scans, 14 (1.4%) thyroid incidentalomas were discovered. The occurrence of incidentalomas by imaging was 2/500 (0.4%) for ultrasound and 12/500 (2.4%) for computed tomography. Three of these nodules (21.4%) were further evaluated with a subsequent ultrasound and due to a size of more than 1 cm underwent fine needle aspiration. Using the Thy classification, all three were given a Thy 2 (non-neoplastic) grading.</p><p><strong>Conclusion: </strong>This study found that there was no clinical benefit to reporting the presence of thyroid incidentalomas incidentally noted on radiology investigations. Although the overall percentage of thyroid incidentalomas is low, this number may be enough to cause unnecessary strain on the healthcare system and burden patients with invasive investigations in addition to causing unnecessary anxiety.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"101-106"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redefining cancer care: the importance of primary care cancer research in Ireland.","authors":"Sean O'Regan, Jack Adams, Benjamin M Jacob, Heather Burns, Patrick Redmond","doi":"10.1007/s11845-024-03864-6","DOIUrl":"10.1007/s11845-024-03864-6","url":null,"abstract":"","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"55-58"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-related volume decrease in subcortical gray matter is a part of healthy brain aging in men.","authors":"Radmila Peric, Igor Romčević, Milica Mastilović, Ivana Starčević, Jasmina Boban","doi":"10.1007/s11845-024-03840-0","DOIUrl":"10.1007/s11845-024-03840-0","url":null,"abstract":"<p><strong>Background: </strong>With the global population aging, the number of individuals over 60 is expected to double by 2050. Brain volume increases until age 13, stabilizes between 18 and 35, then declines by 0.2% annually. Magnetic resonance imaging (MRI) studies highlight significant gray matter atrophy, necessitating differentiation between normal aging and neurodegeneration.</p><p><strong>Aims: </strong>This study assessed the impact of aging on subcortical gray matter in healthy males to identify biomarkers of physiological aging.</p><p><strong>Methods: </strong>A retrospective study of 106 healthy males who underwent brain MRI from 2012 to 2016, divided into two age groups: younger and older than 35 years. MRI scans were performed using a 3 T machine, and volumetric analysis was conducted with VolBrain software. Subcortical gray matter volumes were compared between groups. The Shapiro-Wilk test evaluated normality. Student's t-test and Mann-Whitney U test were used for statistical analysis, with significance defined as p < 0.05.</p><p><strong>Results: </strong>Total intracranial volume was comparable between age groups (p = 0.527). Significant volume reductions (p < 0.05) were observed in subcortical gray matter structures, including the nucleus accumbens, caudate nucleus, globus pallidus, putamen, thalamus, and ventral diencephalon, particularly on the right side in the elderly group.</p><p><strong>Conclusions: </strong>Subcortical gray matter volume in healthy males shows significant differences between older and younger individuals (p < 0.05), with asymmetrical reduction and certain structures on the right aging more rapidly. These findings are significant for distinguishing healthy aging from neurodegeneration.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"339-345"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of programmed sedation care with conventional care in patients receiving mechanical ventilation for acute respiratory failure.","authors":"Jiantang Wang, Yuntao Li, Yujuan Han, Xinyu Yuan","doi":"10.1007/s11845-024-03825-z","DOIUrl":"10.1007/s11845-024-03825-z","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to evaluate the effectiveness of planned sedation therapy in comparison to standard care for patients receiving mechanical ventilation for acute respiratory failure (ARF).</p><p><strong>Method: </strong>The research included a total of sixty individuals who underwent mechanical ventilation for acute respiratory failure (ARF). Utilizing the random number table method, these patients were randomized at random to either the planned sedation care group (Group PSC) or the conventional care group (Group C). The objective was to assess and contrast the impact of treatment on the two groups. Significantly shorter durations of mechanical ventilation, sedative use, ICU therapy, length of stay, incidence of delirium, and adverse events were observed in Group PSC compared with Group C (P < 0.05). A higher 1-month survival rate following mechanical ventilation, a higher post-intervention forced expiratory volume in one second (FEV1) as a percentage of the expected value, a higher post-intervention forced vital capacity (FVC), and a higher patient family care satisfaction rate were observed in Group PSC compared to Group C (P < 0.05).</p><p><strong>Conclusion: </strong>The scheduled administration of sedative therapy in patients receiving mechanical ventilation for acute respiratory failure (ARF) offers significant, reliable, and effective therapeutic benefits.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"289-296"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of lncRNAs as a biomarker for the pregnancy outcomes of gestational diabetes: a meta-analysis.","authors":"Chunling Bao, Jun Kuang, Chuanyong He, Hui Xu","doi":"10.1007/s11845-024-03828-w","DOIUrl":"10.1007/s11845-024-03828-w","url":null,"abstract":"<p><strong>Background: </strong>Long non-coding RNAs (lncRNAs) are tissue-specific and highly stable and may serve as early molecular markers of adverse pregnancy outcomes in patients with gestational diabetes mellitus (GDM).</p><p><strong>Aims: </strong>This study aimed to investigate the relationship between aberrant expression of lncRNAs and adverse pregnancy outcomes in GDM patients.</p><p><strong>Methods: </strong>We searched electronic databases: Embase, Medline, EBSCO, PubMed, CNKI, and Wanfang databases to find relevant articles. Included studies quality was assessed using the QUADAS-2 quality assessment tool. Prognostic value of lncRNAs were pooled using risk ratio (RR) with 95% confidence interval (95%CI). The heterogeneity was analyzed using the Cochran Q test and I² statistical test, and subgroup analyses were performed to explore the sources of heterogeneity. Begg's test funnel plots were analyzed for publication bias.</p><p><strong>Results: </strong>The review included nine studies. Overall, the review found that altered expression of lncRNAs was associated with adverse pregnancy outcomes of GDM patients (RR: 1.616, 95%CI: 1.308-1.996), and was a risk factor for adverse pregnancy outcomes both of Infants (RR: 1.68, 95% CI: 1.30-2.17) and maternal (RR: 4.14, 95% CI: 1.90-9.03) in patients with GDM. The diagnostic procedure, diagnostic criteria, expression trend of lncRNAs, and adverse pregnancy outcomes were the sources of heterogeneity.</p><p><strong>Conclusions: </strong>Aberrant expression of lncRNAs was strongly associated with the adverse pregnancy outcomes in GDM.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"91-100"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effectiveness of telemedicine applications in mental health services: a meta-analysis study.","authors":"Kübra Gülırmak Güler, Sevda Uzun, Elif Güzide Emirza","doi":"10.1007/s11845-024-03841-z","DOIUrl":"10.1007/s11845-024-03841-z","url":null,"abstract":"<p><strong>Aim: </strong>This study was conducted to reveal the effectiveness of telemedicine applications in mental health services.</p><p><strong>Material method: </strong>For this meta-analysis study, data were obtained by searching PubMed, Web of Science, EBSCOhost, Google Scholar, and YÖK Thesis Center databases for the last 5 years in September-December 2023. After the review, 24 studies were included.</p><p><strong>Findings: </strong>In this meta-analysis, it was found that telemedicine interventions in mental health services decreased the depression level of individuals (SMD - 0.168, 95% CI - 0.315 to - 0.021; Z =  - 2.243; p < .05). In addition, it was determined that the duration of the intervention played a role in the effectiveness of telemedicine interventions applied to individuals. In addition, it was determined that the type of intervention, the country where the research was conducted, and the patient group did not play a role in the effectiveness of telemedicine interventions applied to individuals.</p><p><strong>Conclusion: </strong>Telemedicine applications in mental health services can play an effective role in reducing the burden of chronic mental illness and improving patient outcomes.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"233-245"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of early cardiotoxicity in HER2-positive breast cancer patients receiving radiotherapy and concurrent trastuzumab.","authors":"Dicle Aslan, Sadik Ozoner, Mevlude Inanc, Oguz Galip Yildiz, Mehmet Tugrul Inanc","doi":"10.1007/s11845-024-03835-x","DOIUrl":"10.1007/s11845-024-03835-x","url":null,"abstract":"<p><strong>Background: </strong>Overexpression of human epidermal growth factor receptor 2 (HER-2) is associated with aggressive disease in breast cancer. Trastuzumab and radiotherapy are standard treatments for patients with HER-2 + breast cancer, but they may increase the risk of cardiotoxicity.</p><p><strong>Aim: </strong>This study aimed to assess early cardiotoxicity in patients receiving radiotherapy (RT) and concurrent trastuzumab.</p><p><strong>Method: </strong>The study included 116 patients with HER-2 + breast cancer who received concurrent treatment with trastuzumab and RT (52 right-side; 64 left-side). Five left ventricular ejection fraction (LVEF) measurements were performed: one before treatment and four subsequent measurements taken at three-month intervals. LVEF was also assessed before (preRT-EF) and after (postRT-EF) radiotherapy.</p><p><strong>Results: </strong>The baseline LVEF was 62.27 ± 5.5%, while the 12-month LVEF was 59.8 ± 5.8% (p < 0.05). In subgroups, post-RT LVEF values ​​were significantly lower than pre-RT LVEF values (p < 0.05). No significant difference was found between the reduction in LVEF for patients receiving 50 Gy and 60 Gy doses. Moreover, the contribution of regional lymph node irradiation to the decrease in LVEF could not be demonstrated. A positive correlation was found between the total trastuzumab dose and the decrease in LVEF from preRT to postRT. Additionally, a positive correlation was observed between the total taxane dose and the reduction in LVEF from baseline to 9 months, both in the overall group and in the left breast cancer group.</p><p><strong>Conclusion: </strong>In our study,it was found that not only trastuzumab but also taxane-based agents could be cardiotoxic. However, no connection was found between RT doses and the decrease in LVEF.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"7-18"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Undergraduate dermatology education in Ireland: a survey of interns.","authors":"Nicola Kearney, Aislinn Joy","doi":"10.1007/s11845-024-03842-y","DOIUrl":"10.1007/s11845-024-03842-y","url":null,"abstract":"<p><strong>Background: </strong>Dermatological conditions are the fourth most common of all diseases affecting humans, and affect almost one third of the world's population, necessitating effective undergraduate dermatology education.</p><p><strong>Aims: </strong>1. To enquire about the self-perceived confidence of newly qualified junior doctors in recognising and diagnosing dermatological conditions. 2. To ascertain information pertaining to newly qualified junior doctors' undergraduate dermatology education.</p><p><strong>Methods: </strong>A mixed-methods survey on undergraduate dermatology education and self-perceived confidence levels of interns in relation to dermatological conditions was distributed to interns working within two Irish intern networks. Mann-Whitney U testing was used to test for differences between those who had a dermatology placement versus those who did not. Qualitative thematic analysis was used to analyse reflections and comments.</p><p><strong>Results: </strong>Fifty-seven interns completed our survey. A total of 60% of respondents were female (n = 34). The median age range of respondents was 25-29 years. Fifty-eight percent of interns had a clinical dermatology undergraduate placement (n = 33). Forty-nine percent of interns were dissatisfied with their undergraduate dermatology education (n = 28), while 26% (n = 15) were satisfied and 25% (n = 14) indicated neutral feelings. Confidence levels reported were reasonable where inflammatory and malignant dermatoses were concerned. Statistical significance was established across several areas in dermatology between those who had a dermatology placement versus those who did not. Thematic analysis revealed themes of ineffective dermatology education, of a basic knowledge of dermatology, and of dermatology knowledge via other specialties.</p><p><strong>Conclusion: </strong>This study demonstrates that undergraduate dermatology education is not standardised across various universities in Ireland. It also revealed several areas within dermatology within which there was a statistically significant difference in confidence levels between those who had a clinical undergraduate dermatology placement versus those who did not. This raises the question: \"Would mandating a dermatology clerkship may be beneficial to interns?\".</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"107-115"},"PeriodicalIF":1.7,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142686973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}